PB2303: REAL-WORLD TREATMENT PATTERNS AND ADVERSE EVENTS AMONG PATIENTS WITH PERIPHERAL T-CELL LYMPHOMA: A RETROSPECTIVE DATABASE STUDY
Authors: Charles Dharmani, Charles Kearns, Sudhir Unni, Yan Xiong, Maribel Salas, Nabil Said, Ngan Pham, Nazneen Fatimah Shaikh, Xiaoyu Zhou, Aimee Near
Journal: HemaSphere (2023)

Topic: 19. Aggressive Non-Hodgkin lymphoma - Clinical Background: Peripheral T-cell lymphomas (PTCL) are a rare and aggressive form of non-Hodgkin’s lymphoma that develop from mature T-cells and natural killer cells. Due to the diversity of subtypes and rapidly changing treatment landscape, there is limited understanding of the current real-world PTCL population, including their treatment patterns and adverse event (AE) profile of treatments. Aims: This retrospective database study aimed to describe patient characteristics, treatment patterns, and AEs among PTCL patients in the United States. Methods: A retrospective cohort analysis was conducted using IQVIA PharMetrics® Plus claims database to identify adults (≥18 years) with ≥1 inpatient or ≥2 outpatient (≥30 days apart) diagnosis of PTCL (ICD-9 or ICD-10) from April 01, 2011 - November 30, 2021. Patients were required to have evidence of ≥1 systemic treatment for PTCL (excluding steroid monotherapy); the date of first PTCL treatment claim was the index date. All patients were required to have 6 months of continuous enrollment (CE) prior to index date and ≥1 month of CE after index date. Patients with non-PTCL cancer within ±30 days of index date and evidence of systemic PTCL treatment during baseline period were excluded. Three mutually exclusive sub-cohorts based on total number of lines of therapy (LOT) observed during follow-up were created: 1LOT, 2LOT, and ≥3LOT. The three most commonly observed treatment regimens for each LOT sub-cohort were reported. Due to the small sample size, stratification by PTCL subtypes was not feasible. Incident AEs were defined as ≥1 claim for the AE of interest in the primary or secondary position and no claim with such AE during the 6-months prior to LOT start date. AE grades were not available due to the nature of using commercial claims data. Results: A total of 189 PTCL patients were identified, including 117 in the 1LOT, 41 in the 2LOT, and 31 in the ≥3LOT sub-cohorts. Most patients in the LOT sub-cohorts were ≥55 years old, with a male majority. ALCL (42.9%) and PTCL-NOS (38.6%) were the most common subtypes. The most common treatment regimens in the 1LOT were CHOP/CHOP-like, CHOEP/CHOEP-like, and brentuximab vedotin, in the 2LOT were monotherapies (e.g., romidepsin), and in ≥3LOT was brentuximab vedotin (Table 1). Approximately 47.1%, 36.1%, and 38.7% of patients had evidence of incident AEs in the 1LOT, 2LOT, and ≥3LOT regimens, respectively. Overall, the most common incident AEs (1LOT, 2LOT, and ≥3LOT) included neutropenia (25.4%, 11.1%, 16.1%), thrombocytopenia (4.8%, 9.7%, 12.9%), fatigue (11.6%, 9.7%, 12.9%), and anemia (9.5%, 6.9%, 0%). In the 1LOT regimen, patients on combination therapies, such as CHOP/CHOP-like (53.1%), CHOEP/CHOEP-like (63.2%) and brentuximab vedotin/cyclophosphamide/doxorubicin (35.7%), had higher frequency of incident AEs compared to brentuximab vedotin monotherapy (19.2%). Summary/Conclusion: Treatment regimens observed among PTCL patients were consistent with NCCN treatment guidelines, with higher utilization of combination therapies in the 1LOT and higher utilization of monotherapies in subsequent LOTs. Higher frequency of AEs were observed with combination therapies than monotherapy. This study provides evidence that AEs were frequent in all LOTs, suggesting current combination therapies may lack adequate tolerability. However, monotherapies displayed a better safety profile than traditional chemotherapy combinations in the 1LOT regimens. Future studies are warranted with larger sample sizes to fully capture the safety profile associated with systemic PTCL treatments.Keywords: Peripheral T-cell lymphoma, Real world data, Adverse reaction